TY - JOUR
T1 - Disease activity following pregnancy-related discontinuation of natalizumab in MS
AU - Kleerekooper, Iris
AU - van Kempen, Zoé L. E.
AU - Leurs, Cyra E.
AU - Dekker, Iris
AU - Rispens, Theo
AU - Lissenberg-Witte, Birgit I.
AU - van Munster, Caspar E. P.
AU - de Jong, Brigit A.
AU - van Oosten, Bob W.
AU - Uitdehaag, Bernard M. J.
AU - Wattjes, Mike P.
AU - Killestein, Joep
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Objective: To investigate disease activity and disability progression following pregnancy-related discontinuation of natalizumab (NTZ) in patients with relapsing-remitting MS. Methods: A retrospective cohort study of clinical and radiologic data in patients who discontinued NTZ for pregnancy-related reasons. Results: Twenty-two pregnancy-related NTZ discontinuations in 17 patients were evaluated. The median time to conception was 3.4 months. Relapses were more frequent in patients in whom conception did not occur within 6 months (p = 0.022). Confirmed disability progression occurred in 27.3% and was associated with time to conception (p < 0.001). Conclusions: Early conception after NTZ discontinuation is associated with a reduced risk of disease activity and disability progression. Continuation of NTZ treatment until confirmed pregnancy should be considered in patients with previously active MS. However, the advantages of continuing the drug until pregnancy should be balanced against the uncertainties in postnatal outcomes.
AB - Objective: To investigate disease activity and disability progression following pregnancy-related discontinuation of natalizumab (NTZ) in patients with relapsing-remitting MS. Methods: A retrospective cohort study of clinical and radiologic data in patients who discontinued NTZ for pregnancy-related reasons. Results: Twenty-two pregnancy-related NTZ discontinuations in 17 patients were evaluated. The median time to conception was 3.4 months. Relapses were more frequent in patients in whom conception did not occur within 6 months (p = 0.022). Confirmed disability progression occurred in 27.3% and was associated with time to conception (p < 0.001). Conclusions: Early conception after NTZ discontinuation is associated with a reduced risk of disease activity and disability progression. Continuation of NTZ treatment until confirmed pregnancy should be considered in patients with previously active MS. However, the advantages of continuing the drug until pregnancy should be balanced against the uncertainties in postnatal outcomes.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85044298209&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29379823
UR - http://www.scopus.com/inward/record.url?scp=85044298209&partnerID=8YFLogxK
U2 - https://doi.org/10.1212/NXI.0000000000000424
DO - https://doi.org/10.1212/NXI.0000000000000424
M3 - Article
C2 - 29379823
SN - 2332-7812
VL - 5
JO - Neurology® neuroimmunology & neuroinflammation
JF - Neurology® neuroimmunology & neuroinflammation
IS - 1
M1 - e424
ER -